A Lifeline for Women Facing Bladder Cancer

March 23, 2026

Transcript

Voice over:

This is Bladder Cancer Matters, the podcast for bladder cancer patients, caregivers, advocates, and medical and research professionals. It’s brought to you by the Bladder Cancer Advocacy Network, otherwise known as BCAN. BCAN works to increase public awareness about bladder cancer, advances bladder cancer research, and provides educational and support services for bladder cancer patients and their loved ones. To learn more, please visit B-C-A-N dot O-R-G.

Rick Bangs:

Hi, I’m Rick Bangs, the host of Bladder Cancer Matters, a podcast for, by and about the bladder cancer community. I am also a survivor of muscle invasive bladder cancer, the proud owner of a 2006 model year neobladder and a patient advocate supporting cancer research at the Bladder Cancer Advocacy Network, or as many call it BCAN, producers of this podcast.

I’m pleased to welcome today’s guest, Bree Duncan. Bree is originally from Schaumburg, Illinois and she has a bachelor’s in nursing. Bree has been a nurse with Vanderbilt Urology at Vanderbilt University Medical Center in Nashville, Tennessee for the last 12 years. Bree is currently in a brand new role, the care coordinator for female bladder cancer. This role was specifically created to provide the unique support needed by women with bladder cancer and is possible thanks to a generous gift from a grateful patient back in 2022. Bree currently splits her time between running clinical trials and her female bladder cancer care coordinator role.

Bree, thanks for joining our podcast.

Bree Duncan:

Hi, Rick. Thank you for having me. I’m thankful for this opportunity to chat with you and tell everybody about how we’re helping patients over here and just all because of this grateful patient and how she wanted to help make a difference for others.

Rick Bangs:

I was so excited when I heard from Dr. Sam Chang, who’s with Vanderbilt. He’s also a member of the BCAN Scientific Advisory Board, so some listeners might recognize that. He mentioned this role to me, and in this role you focus specifically on women with bladder cancer. So what was the catalyst for creating this role?

Bree Duncan:

Bladder cancer affects men significantly more than women. And actually, according to the BCAN website, it’s estimated that about 82,000 new cases of bladder cancer are diagnosed every year, and approximately three quarters of those are in men, with the remaining only 25% of cases being women. So because of this, there are more resources and support for men, which makes sense. So we wanted to do something that would help provide more support to those women being diagnosed with bladder cancer.

Rick Bangs:

Okay. I mentioned this in the intro. There was a generous gift. So tell us about that.

Bree Duncan:

It all started from a grateful patient of Dr. Chang’s, who saw the need as bladder cancer patient herself and wanted to help make a difference for patients that would walk through our doors after her. Dr. Chang and Mrs. Kramer got together and they came up with the idea of a care coordinator role specifically to help women with bladder cancer. I personally had known Mrs. Kramer prior to starting this position through my work on clinical trials. So we had formed a relationship, and when they asked me if I would fulfill this role, I was very honored to help carry out her vision to help other women. So the work as extra special to me because of this. Sadly, Mrs. Kramer has since passed away, but her wonderful family actually continues to support this idea that she had and helps keep funding it through different initiatives.

Rick Bangs:

Let’s get to the heart of this. What do you do in this role?

Bree Duncan:

The goal is to one day find a way to help all the women that walk through our doors with bladder cancer. Since this is only part of my work, with the other part being in clinical trials, we’re focusing my efforts and time on the women with more advanced disease, specifically women who end up having their bladders removed with a radical cystectomy. So we felt like these were the patients that could use the greatest support. Currently, where I’m focusing my time in this role, I meet these women and their families at their new patient appointment with our doctors where they’re discussing their history, the different options, and hopefully at that visit, we’re also coming up with a plan of care for moving forward. So I give them my contact information, which has everything on it. Any way that they want to get in touch with me, I have an option on their forum. I tell them, in one of those options is actually a cell phone that we got specifically for this role. That way, women could reach out to me via a phone call or a text.

That was one of the biggest things, goals with this role was to find a way to provide easy accessibility for questions or concerns. And I like to remind them that no question is too big or too small. If it’s on their mind, I encourage them to reach out. I think what I had heard before is a lot of patients are always like, “You guys are so busy. We don’t want to bother you with small questions.” I like to remind them that that’s one of the benefits of this role, is that they can reach out to me with all of those questions. The goal is to relieve some of their fears, provide answers, and bring peace during a journey that is so scary and overwhelming for most of them.

After this initial appointment and getting to know each other, going forward, I try to attend any of their appointments that they may have prior to surgery, visit them while they’re in the hospital because usually here for about four to six days. And then I also attend their initial follow-up appointments. Typically try to stay involved with them up until the three or six month mark, and of course, I’m always available to them after, but my regular check-ins and stuff goes up until about that point. I also check in them along their whole journey to see if they have any questions, how they’re recovering, just make sure that all their appointments are getting scheduled according to the plan.

Vanderbilt is really truly such a wonderful place. We have a lot of different doctors, providers, nurses and staff, and so I try to be their constant and familiar face on that journey and to, in a sense, be a friend because I feel like going through something so scary, everyone just needs someone in their corner. So it is nice when you walk into the room and they recognize obviously who I am and just you can tell there’s a sense of peace that someone else is there to help them with any questions and stuff.

I think it’s really helpful to have another female fulfilling the role. I don’t have experience necessarily with bladder cancer specifically, but I think having a female helps create another safe space to talk about topics that may be important to women, topics that they may not want to share with their doctor, especially if they have a male doctor. So that’s topics like sexual function, body image, what’s going to happen in surgery when maybe the doctor’s going to remove some other female organs. So I think education is really important to help these women feel prepared. We actually use a lot of the BCAN resources as a tool to discuss and provide to these patients.

Rick Bangs:

Yeah, I am really impressed with how comprehensive this is. This is really wonderful. So tell me, trying to make some distinction, what’s different for the women with whom you interact different from what would’ve happened historically or might happen in other contexts that are outside of Vanderbilt.

Bree Duncan:

I’m not sure if I can necessarily speak to how it was for the women before this role was created or how it is at other facilities, but I do know that I feel like we’re making a difference with this role. I’m able to help triage issues that come up and get the doctor involved early to prevent emergency room visits, which we’ve seen happen. Sometimes we can… Maybe we know someone does have to be admitted to the hospital without having to necessarily send them through the ER, which is not a fun process for anybody.

Rick Bangs:

Never.

Bree Duncan:

We can work on direct admits. I know that had this role not been there, those options might not be available to those patients. So it’s nice to see that as a positive from the role. I’m also, like I mentioned before, able to get patient answers quickly. With them having direct access to me, they’re able to reach out with questions and I’m hopefully able to get those answers quickly. I always tell them, if I don’t know the answer, I know who to reach out to get the answer. And so I’m hopeful by getting questions answered quickly, able to help ease some of their fears and hopefully make it for an easier and quicker recovery.

Vanderbilt urology is such a large clinic. Again, we have such a wonderful staff, but it’s hard to get patients answers to their questions quickly because of just the sheer volume of patients and messages that we get. So this role helps these patients with their needs, but also helps support some of the staff by easing a little bit of the workload. Of course, they have a lot of other patients that they help, but if I can help in any way with just the female bladder cancer patients, it’s nice to help support them.

Rick Bangs:

Are there specific measures of success or any anecdotes that you can share that give us a better sense for the impact you’re having in this role?

Bree Duncan:

We’ve been working on ways to capture this data of how we’re actually helping patients and put real numbers to the impact. I now am doing a lot of tracking of what I’m doing in a database so we can help run reports and things like that. As time goes on and I see more patients is getting harder to just rely on my memory for it all. So the database is going to help us with that. We’re also talking about working on some patient satisfaction tools, again, to just help provide some real data versus just my experience from it. But just on a human level, I know we’re making a difference. I’ve been on the receiving end of a lot of hugs and tears from these patients and their families for their appreciation of what we’re doing. And so to me, that’s all I really need to know to know that we’re making an impact.

Rick Bangs:

Yeah, you’re definitely fulfilling the vision here. Talk about how the roles evolve since you started conceptualizing it way back in 2022. Are there any lessons learned?

Bree Duncan:

The role has grown a lot since 2022. The initial phase was truly just figuring out what I could offer that would make a difference, how do we do this, I guess. And then it became more about getting immersed in the care that we’re providing to these women and educating myself. While I previously treated women with bladder cancer through my work in research trials, I still had a lot to learn on the things that we were doing in the clinical setting for these women. As I mentioned, we came to the conclusion early on that providing extra support to the women with the more advanced disease who typically move on to having a radical cystectomy proved to be where I was able to make the most difference.

The only real lesson learned at this point was just start documenting everything early from the beginning. It’s easier than trying to rely on my memory of all the different things that we’ve tried and gone through. So documenting, we’ve started it about halfway through, but starting early on is definitely one of the things I wish we would’ve done sooner.

Rick Bangs:

Yeah, it also sounds like an opportunity for an article, but I will let you guys decide on that. All right. What other opportunities could you see for similar roles that might focus on a specific type of patient?

Bree Duncan:

I truly think all patients would benefit from a role like this, but as we know, it’s just not possible with how overwhelmed the healthcare system is. So the reason I’m able to do this is because I’ve been given the ability to focus my efforts on a smaller group of patients, which allows me to give each of them more time. However, I think it would be so great to see a role like this for all different cancer subspecialties.

Rick Bangs:

Yeah, definitely some opportunities pretty universally for some populations. That would be awesome. All right. What advice would you give to a nurse who’s at another institution and might actually be listening to this podcast and this person is thinking, “A role like this would have great potential at my institution”? So what advice do you have for that person?

Bree Duncan:

We would love to see other doctors or nurses be inspired to do something like this at their institution. It would mean that we’re helping make a difference outside of our Vanderbilt walls, which would be amazing. It all starts with a conversation on how to make that happen. We were blessed with the Kramer family to help start those conversations for us. But like I said, all it starts is just a conversation of how to make it happen. And I’m always happy to talk with others about how we did it and things we’ve learned and what works and where we’ve made the most impact. Dr. Chang and I were actually recently contacted by a cancer center in the Netherlands who read about this role and is hoping to incorporate this into the care that they provide.

Rick Bangs:

Oh, cool.

Bree Duncan:

So it’s exciting to see this idea grow outside of just our clinic.

Rick Bangs:

Yeah, let’s hope we see more of that.

Bree Duncan:

Yes.

Rick Bangs:

All right. Any final thoughts?

Bree Duncan:

Thank you again for this opportunity to talk about this role. It means a lot to me to be able to care for these patients. It’s a role that is close to my heart, and so I appreciate any opportunity to talk about it. All of it is possible really because of the Kramer family, Dr. Chang, and then all the staff and providers that I work with that provide such excellent care to our patients.

Rick Bangs:

Yeah, thanks to all of them. They’ve done something wonderful here.

Bree, I want to thank you for helping us understand some of the opportunities to better care for women with bladder cancer.

If you’d more information on bladder cancer, please visit the BCAN website, www.bcan.org.

In case people wanted to get in touch with you, could you share some kind of contact information?

Bree Duncan:

Yeah, I’m happy to share my email address. And like I said, anyone can reach out. I’m happy to connect with anyone. My email address is [email protected]. That’s B-R-I-A-N-N-E, dot Duncan, D-U-N-C-A-N, at V-U-M-C dot org.

Rick Bangs:

Excellent. Thank you.

Just a reminder, if you’d like more information about bladder cancer, you can contact the Bladder Cancer Advocacy Network at 1-888-901-2226. That’s all the time we have today. Please like, comment, and subscribe so we have your feedback. Thank you for listening and we’ll be back soon with another interesting episode of Bladder Cancer Matters.

Thanks again, Bree.

Bree Duncan:

Thanks, Rick.

Voice over:

Thank you for listening to Bladder Cancer Matters, a podcast by the Bladder Cancer Advocacy Network, or BCAN. BCAN works to increase public awareness about bladder cancer, advanced bladder cancer research, and provide educational and support services for bladder cancer patients. For more information about this podcast and additional information about bladder cancer, please visit B-C-A-N dot O-R-G.